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Tuesday, Nov. 20, 2018

Explaining Causes Of Dementia

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Alzheimer’s is the most common disorder

Many people feel that dementia is to be distinguished from Alzheimer’s disease, but this is not the case. Dementia is a generic term for progressive cognitive impairment, which can include forgetfulness, difficulty performing certain familiar tasks, as well as personality change with a tendency toward social withdrawal.

There are many potential causes of dementia including traumatic brain injury, stroke, brain infection, the result of a drug overdose with secondary hypoxic insult to the brain, following cardiac arrest as well as genetic predisposition.

The term neurodegenerative disease reflects disorders which result in progressive impairment in pathways of brain function and can include Alzheimer’s disease, Parkinson’s disease, Dementia with Lewy Bodies, Frontotemporal Dementia, Lou Gehrig’s disease (ALS) and so-called Parkinson’s Plus disease variants such as Progressive Supranuclear Palsy. These disorders become more common as people age and are typically associated with “slowing down” in general.

Alzheimer’s disease is the most common neurodegenerative disorder associated with dementia and is becoming increasingly more prevalent as people live longer related to effective therapies for heart disease and cancer. Unfortunately, there are no “home run” drugs for Alzheimer’s disease, although the two classes of drug presently available, acetylcholinesterase inhibitors (such as Aricept and Exelon) and the N-methyl-D-aspartate inhibitor (Namenda), meantime may provide some benefit. The focus of therapy for Alzheimer’s disease includes the common use of these two forms of medication.

Also, and of primary importance, is to prevent development, or progression, of dementia related to Alzheimer’s disease by avoiding factors that can contribute to dementia. Such factors include concussions, smoking, alcohol abuse, illicit drug use, certain medications and suboptimal attention to a healthy lifestyle. A healthy lifestyle should incorporate an appropriate diet and exercise program as well as control of risk factors for vascular diseases such as hypertension, hyperlipidemia and diabetes mellitus.

If you, or a loved one, are suffering from clinically significant memory loss or other loss of cognitive function, it is important to get this checked out by your healthcare provider. This could be reflective of a medication effect, a vitamin deficiency, significant depression or a thyroid disorder, all of which are very treatable, versus some process that may require a brain scan, EEG or other diagnostic testing to determine the most appropriate course of action.

With dementia, it is important for family members to establish a safe environment. This must factor in things we often take for granted such as loss of ability to drive safely, loss of the sense of smell, which can lead to consumption of tainted food and failure to detect smoke in the house, as well as the need for supervision of the finances and efforts to prevent falls.

It is important to recognize that, even with dementia of the Alzheimer’s type, a relatively high quality of life can be maintained for a significant period of time with proper attention to and accommodation of the identified limitations, which we might all eventually face, as part of the “luxury of growing older.”

Roger Kelley, chairman, Department of Neurology, LSU Health Shreveport.

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